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Home / IAS Preparation / Ayushman Bharat UPSC

Ayushman Bharat UPSC: Objective, Components, Challenges & More

Last Updated on Feb 07, 2025
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Ayushman Bharat is one of the flagship health programs undertaken by the Government of India. The program intends to provide free medical treatment to millions of deprived, disadvantageous families. To an UPSC aspirant, it is an important topic for knowledge because Ayushman Bharat UPSC embodies critical elements of governance and public policy. The scheme helps to reduce the economic burden of health care expenses on the economically weaker sections. The program offers health insurance and digital health records by the government. It also supports preventive healthcare and medical services. Medical services are available to all beneficiaries through an Ayushman Bharat Card. Let's find out more about this scheme.

The Ayushman Bharat Yojna is an important topic in General Studies Paper II of the UPSC Mains. It focuses on public health, social justice, and government welfare schemes. The topic explores its role in universal healthcare, financial protection, and digital health integration, while addressing challenges like awareness, infrastructure gaps, fraud prevention, and accessibility in rural areas.

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GS Paper

General Studies Paper II

Topics for UPSC Prelims

Ayushman Bharat Scheme, PM-JAY, Healthcaōre Infrastructure, National Health Authority

Topics for UPSC Mains

Ayushman Bharat Scheme and its Objectives, Evaluation of Impact on Healthcare Accessibility and Affordability, Role of National Health Authority, Indian Healthcare System

What is Ayushman Bharat?

Ayushman Bharat is a health scheme started by the Government of India. It helps poor families get free medical treatment. The scheme covers hospital bills up to ₹5 lakh per family each year. It includes treatments for serious diseases. People can use an Ayushman Bharat Card for cashless treatment.

This scheme has two parts: Health and Wellness Centers (HWCs) and Pradhan Mantri Jan Arogya Yojana (PMJAY). HWCs provide basic healthcare services. Ayushman Bharat PMJAY covers expensive hospital treatments. The government launched this scheme to reduce medical costs for poor people. Many hospitals accept this scheme for free treatment.

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Objectives of Ayushman Bharat

Ayushman Bharat provides free health to poor families. It cuts the cost of treatment and delivers quality treatment services. The scheme enhances primary care delivery, allows digital health records, and delivers cashless hospitalization, making health affordable and accessible to its users. There are some important objectives of the Ayushman Bharat Yojna.

Provide Free Healthcare

The scheme offers free medical treatment to poor families. It covers hospital bills up to ₹5 lakh per family each year. This helps people get proper treatment without worrying about money. It reduces the financial burden on low-income families. Many hospitals provide treatment under this scheme.

Reduce Medical Expenses

Ayushman Bharat Yojna has the aim to reduce healthcare expenses. Most of the families face problems while paying hospital bills. This scheme provides them with necessary treatment. It gives financial protection against heavy medical expenses. There is no need for borrowing money for hospital treatments.

Strengthen Primary Healthcare

The scheme sets up Health and Wellness Centers (HWCs). These centers provide free medicines, vaccinations, and check-ups. They help in detecting diseases early. Early detection leads to better treatment. This improves the overall health of people in rural and urban areas.

Ensure Cashless Treatment

People can use the Ayushman Bharat Card to get free treatment. The card allows hospitals to treat patients without charging them. This removes the need for cash transactions. It makes the hospital process easy for poor families. They do not have to arrange money before treatment.

Promote Digital Health Records

The Ayushman Bharat Digital Mission creates a unique health ID for each person. This ID stores medical records safely. Doctors can access patient history easily. It reduces paperwork in hospitals. It also helps doctors give better treatment based on past medical records.

Increase Healthcare Access

The Ayushman Bharat Scheme ensures that healthcare reaches every corner of India. Many people in villages do not have hospitals nearby. This scheme connects them with good hospitals. It also encourages more private hospitals to treat poor patients. This improves overall healthcare services in the country.

Support Vulnerable Groups

The scheme helps poor people, laborers, street vendors, and other low-income workers. Many of them cannot afford expensive treatments. Ayushman Bharat PMJAY ensures they get the best medical care. The scheme also supports pregnant women, elderly people, and disabled persons.

Improve Public Health System

This scheme strengthens government hospitals. It provides funding for better medical equipment. More doctors and nurses are appointed under this scheme. It helps hospitals serve more patients. The government also ensures hospitals maintain proper healthcare standards.

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Key Components of Ayushman Bharat Scheme

The Ayushman Bharat Scheme has three key components. Health and Wellness Centers (HWCs) provide primary healthcare services. PMJAY covers hospital expenses. Ayushman Bharat Digital Mission promotes digital health records and telemedicine services.

Health and Wellness Centers (HWCs)

  • The government is upgrading 1,50,000 sub-centers and primary health centers into HWCs.
  • These centers focus on preventive and promotive healthcare.
  • They provide free diagnostic tests, medicines, and maternal care services.
  • HWCs also conduct counseling for mental health, non-communicable diseases (NCDs), and lifestyle disorders.
  • Special focus is given to child healthcare, elderly care, and vaccinations.

Pradhan Mantri Jan Arogya Yojana (PMJAY)

  • Ayushman Bharat PMJAY provides cashless hospitalization coverage.
  • The scheme covers pre-existing diseases, surgeries, and medical treatments.
  • No cap on family size or age, ensuring comprehensive coverage.
  • Over 1,500 treatment packages are covered, including critical illnesses.
  • Treatment is available at government and empaneled private hospitals.

Ayushman Bharat Digital Mission (ABDM)

  • The Ayushman Bharat Digital Mission (ABDM) aims to digitize healthcare services.
  • Citizens get a unique digital health ID to store medical records.
  • This ID allows patients and doctors to access medical history securely.
  • Paperless and efficient healthcare delivery reduces documentation hassles.
  • Encourages the use of telemedicine, e-pharmacies, and digital consultations.

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Ayushman Bharat PMJAY: The Insurance Scheme

Ayushman Bharat PMJAY provides free health insurance to poor families. It covers hospital bills up to ₹5 lakh per year. The scheme ensures cashless treatment in government and private hospitals. It helps people get medical care without financial stress.

How Does Ayushman Bharat PMJAY Work?

Ayushman Bharat PMJAY offers cashless hospitalization benefits for serious illnesses. The government pays the hospital bills directly. The scheme covers:

  • Pre-existing diseases from the first day.
  • Medical expenses before and after hospitalization.
  • Surgeries including heart surgery, kidney transplant, and cancer treatment.
  • Diagnostic tests and medicines.
  • Maternity care for pregnant women.

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Ayushman Bharat Eligibility

Many people ask, "What is Ayushman Bharat eligibility?". The eligibility is based on the Socio-Economic Caste Census (SECC) 2011 data.

Who Can Apply for Ayushman Bharat?

Rural Beneficiaries

  • Families with no male member aged 16-59.
  • Households with disabled members.
  • Scheduled Caste (SC) and Scheduled Tribe (ST) families.
  • Landless households depending on daily labor.

Urban Beneficiaries

  • Street vendors, domestic workers, rickshaw pullers, construction workers.
  • Plumbers, electricians, and sanitation workers.
  • Small shop owners and other low-income groups.

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Importance of Ayushman Bharat Scheme

The Ayushman Bharat Scheme is important for India's healthcare system. It provides free treatment, reduces medical costs, and improves hospital access. It also strengthens digital healthcare and creates jobs in the health sector.

Provides Financial Protection

  • Many people in India face high medical expenses.
  • Ayushman Bharat Card enables cashless treatment and reduces financial stress.
  • The scheme ensures that poor families do not fall into debt due to healthcare costs.

Promotes Universal Healthcare

  • Ayushman Bharat PMJAY helps achieve universal health coverage (UHC).
  • The scheme provides access to quality healthcare for all citizens, especially the poor.
  • Strengthens rural and urban healthcare infrastructure.

Improves Healthcare Accessibility

  • Ayushman Bharat Yojna provides healthcare facilities across the country.
  • Expands the network of hospitals and wellness centers.
  • Reduces the burden on public hospitals by involving private hospitals.

Strengthens Digital Health Infrastructure

  • The Ayushman Bharat Digital Mission promotes electronic health records.
  • Encourages telemedicine and online consultations, making healthcare accessible from remote areas.
  • Reduces paperwork and enhances patient data security.

Creates Employment Opportunities

  • More hospitals and health centers mean more jobs for doctors, nurses, and healthcare workers.
  • Strengthens the medical workforce and research in India.

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Challenges of Ayushman Bharat Scheme

The Ayushman Bharat Scheme faces many challenges. Many people are unaware of it. Public hospitals are overcrowded. Fraudulent claims increase costs. Private hospitals hesitate to join. Digital access remains a problem in rural areas.

Low Awareness and Accessibility Issues

  • Many beneficiaries do not know about Ayushman Bharat eligibility.
  • Some remote areas lack empaneled hospitals for treatment.

Shortage of Healthcare Facilities

  • Overburdened public hospitals lead to long waiting times.
  • Some regions lack sufficient doctors and medical equipment.

Fraudulent Claims and Misuse

  • Some private hospitals file false claims under Ayushman Bharat PMJAY.
  • Strict monitoring and fraud detection systems are needed.

Limited Participation from Private Hospitals

  • Payment delays discourage private hospitals from participating.
  • Need for better incentives and timely reimbursements.

Digital Divide

  • Ayushman Bharat Digital Mission needs internet connectivity and digital literacy.
  • Some rural beneficiaries struggle to use digital health records.

Key Takeaways for UPSC Aspirants

  • Launched: 2018, under Pradhan Mantri Jan Arogya Yojana (PM-JAY)
  • Purpose: Universal Health Coverage with financial protection against catastrophic health expenditure
  • Coverage: Health insurance cover for hospitalization in secondary and tertiary care up to ₹5 lakhs per family per year
  • Beneficiaries: The Scheme targets more than 10 crore families at the bottom of the pyramid, who have been identified based on the Socio-Economic Caste Census.
  • Salient Features: Cashless and paperless access to health services for the beneficiaries at any public or private empanelled hospital in the country.

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Conclusion

Ayushman Bharat is India's game-changing health scheme. It gives financial coverage, superior quality of treatment, and digital health care records. Ayushman Bharat Yojna enables poor families to receive free medical treatment. The Ayushman Bharat Card enables the beneficiary to avail cashless treatment at the empaneled hospitals. Ayushman Bharat PMJAY covers the expenses that occur in the hospital, and the Ayushman Bharat Digital Mission facilitates digital healthcare.

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Ayushman Bharat UPSC FAQs

Ayushman Bharat Yojna is the government health care scheme which will provide free of cost health insurance coverage of ₹5 lakh per family per year for the economically poor and vulnerable groups.

To check your eligibility for Ayushman Bharat, you can use the official Ayushman Bharat PMJAY website using either your Aadhaar or mobile number.

It is an ID card that brings in cashless treatments at any of the empanelled hospitals. The benefit eligible can avail it by log-in to its official website. Through Ayushman Bharat login download the cards and get medical services.

Ayushman Bharat PMJAY makes it possible to obtain cashless hospitalization, where the most expensive treatments come with cashlessness and the governments pays the respective hospitals' bill.

Ayushman Bharat Digital Mission is an initiative providing a unique health ID for each citizen for securely storing and accessing digital medical records.
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